Failing Dental Implants Part II
I was in Chinatown in Boston over the weekend visiting my son at Tufts College of Dental Medicine. (He’s 50% a dentist. If you need to fix half a tooth, he’s your man.)
I passed a Chinese Restaurant named: “FU Wing”. Apparently somebody has an issue with wings.
In the last article, “How Do You Diagnose a Failing Dental Implant?” we discussed diagnosing failing dental implants and how we classify each category based on the CE Misch DDS “Quality of health Implant Scale.” Here is how we treat each category:
Group I, Successful implant: no pain, mobility, or exudate (puss), and less than 2 millimeters of bone loss seen on an X-ray.
No treatment needed.
Group II, Satisfactory survival: Same as above, but X-ray shows 2 to 4 millimeters of bone loss.
Treatment: Have the hygienist numb the area and use Teflon coated scalers to clean out the pockets, then place Arestin; antibiotic granules injected under the gum line. Patients have to use dental yarn to clean the implants at home, plus a water pick with Peridex oral rinse. This should be done every three to four months.
Group III, Compromised survival: Same as above, but X-ray shows more than 4 millimeters of bone and a periodontal pocket depth of more than 7 millimeters. This implant may not be salvageable.
Treatment: We make a surgical flap to expose the implant, debride out infected tissue, add freeze dried bone grafts, cover it with a collagen membrane and suture the flap closed. This heals in four months. Sometimes the crowns or bridge may need to be re-done.
Group IV, Failure: pain on chewing, mobility, X-ray shows bone loss of momre than half the length of the implant, and uncontrolled exudate (puss).
Treatment: Cold steel and sunshine. The implants are removed, the area bone grafted and four months later, we place new implants.
Please feel free to email me any questions!
Dr. Mitchell Josephs practices Implant, Cosmetic and General Dentistry with an emphasis on implants, porcelain veneers, and complex crown and bridge treatment. He is on staff at JFK Medical Center and is a Faculty Advisory Board member at McGill University’s Faculty of Dentistry. He completed his residency at Manhattan’s Beth Israel Medical Center and Mt. Sinai Hospital.